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首页> 外文期刊>Acta Radiologica >Reproducibility of dynamic computed tomography brain perfusion measurements in patients with significant carotid artery stenosis.
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Reproducibility of dynamic computed tomography brain perfusion measurements in patients with significant carotid artery stenosis.

机译：动态计算机断层扫描脑灌注测量在具有严重颈动脉狭窄的患者中的可重复性。

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BACKGROUND: Perfusion computed tomography (PCT) determination is a minimally invasive and widely available technique for brain blood flow assessment, but its application may be restricted by large variation of results. PURPOSE: To determine the intraobserver, interobserver, and interexamination variability of brain PCT absolute measurements in patients with significant carotid artery stenosis (CAS), and to evaluate the effect of the use of relative perfusion values on PCT reproducibility. MATERIAL AND METHODS: PCT imaging was completed in 61 patients before endarterectomy, and in 38 of these within 4 weeks after treatment. Cerebral blood flow (CBF), cerebral blood volume (CBV), time to peak (TTP), and peak enhancement intensity (PEI) were calculated with the maximum slope method. Interexamination variability was evaluated based on perfusion of hemisphere contralateral to the treated CAS, from repeated examinations. Interobserver and intraobserver variability were established for the untreated side, based on pretreatment examination. RESULTS: Interobserver and intraobserver variability were highest for CBF measurement (28.8% and 32.5%, respectively), and interexamination variability was the highest for CBV (24.1%). Intraobserver and interobserver variability were higher for absolute perfusion values compared with their respective ratios for CBF and TTP. The only statistically significant difference between perfusion values measured by two observers was for CBF (mean 78.3 vs. 67.5 ml/100 g/min). The interexamination variability of TTP (12.1%) was significantly lower than the variability of other absolute perfusion measures, and the interexamination variability of ratios was significantly lower than absolute values for all the parameters. CONCLUSION: In longitudinal studies of patients with chronic cerebral ischemia, PCT ratios and either TTP or CBV are more suitable measures than absolute CBF values, because of their considerably lower inter- and intraobserver variability. Differences in CBF between two examinations as high as 30% may be considered as significant in such patients.
机译：背景：灌注计算机断层扫描（PCT）确定是一种微创且可广泛用于脑血流评估的技术，但其应用可能会受到结果差异较大的限制。目的：确定患有严重颈动脉狭窄（CAS）的患者脑内PCT绝对值的观察者内，观察者间和检查间变异性，并评估相对灌注值对PCT可重复性的影响。材料与方法：PCT成像在61例动脉内膜切除术前完成，其中38例在治疗后4周内完成。用最大斜率法计算脑血流量（CBF），脑血容量（CBV），到达峰时间（TTP）和峰增强强度（PEI）。通过反复检查，根据与治疗过的CAS对侧的半球灌注情况评估检查间变异性。根据治疗前检查确定未治疗者的观察者间和观察者内变异性。结果：观察者间和观察者内变异性最高的CBF测量（分别为28.8％和32.5％），而检查间变异性最高的是CBV（24.1％）。绝对灌注值的观察者间和观察者间变异性高于其各自的CBF和TTP比率。两位观察者测得的灌注值之间唯一的统计上显着差异是CBF（平均78.3 vs. 67.5 ml / 100 g / min）。 TTP的检查间变异性（12.1％）明显低于其他绝对灌注量度的变异性，并且比率的检查间变异性显着低于所有参数的绝对值。结论：在对慢性脑缺血患者的纵向研究中，PCT比率和TTP或CBV比绝对CBF值更合适，因为观察者间和观察者间的变异性较低。两次检查之间的CBF差异高达30％，在此类患者中可能被认为是显着的。

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